A Good Endo is Hard to Find

Some of my best friends are endocrinologists. But a primary care physician treats my diabetes.

Dr. Jeff Gerber is an outstanding doctor who is up-to-date on diabetes, weight loss, and nutrition. While his office south of Denver is about an hour from my home in Boulder, he more than makes up for this geographical undesirability by scheduling appointments quickly and by being easily reached by email and phone.

I don’t need to see an endo now. I had an endo when I lived in Santa Cruz and my blood glucose levels were higher. That’s one of the times that people with diabetes should seek out an endo.

There aren’t enough endos to go around. We had only 2,389 endos in office-based practice in 1999, the most recent data I’ve found and probably little changed since then.

About 20.8 million Americans – 7 percent of us – have diabetes, according to the government’s latest data at “National Diabetes Fact Sheet”. Of these people, 14.6 million already have their diagnosis.

That means we have about 2,389 endos for the 14.6 million people who know they have diabetes. That works out to 6,111 people with diabetes per endo.

Those numbers aren’t hard to find. But until this week I had puzzled over what the missing number was. What we also need to know is what the typical patient load that endos have.

This week while doing some consulting in Boston at the Joslin Diabetes Center, I met with two leading endos who answered my question. Colonel Robert Vigersky, M.D., is the medical director of the Diabetes Institute at the Walter Reed Army Medical Center in Washington. He is the corresponding author of the study in The Journal of Clinical Endocrinology & Metabolism linked above. Paul Conlin, M.D., is the chief of the endocrinology section of the VA Boston Healthcare System and associate professor of medicine at Harvard Medical School.

They agreed that endos can see no more than 1,000 patients per year. That means fewer than one-sixth of those of us with diagnosed diabetes can get an appointment with one.

No wonder it’s so hard to get an appointment with an endo! When we try to get our first appointment with one, we have to wait an average of 37 days. That’s longer than we have to wait for any other medical specialist.

One of my best friends is Dr. Bill Quick. Bill used to be in private practice as an endo in the Midwest, but is now a director in the global pharmacovigilance department at the Schering-Plough Research Institute in New Jersey. Each of us started our websites about diabetes more than a decade ago, and we have worked together ever since. He also has his own blog here.

About 5 or 6 years ago a magazine editor gave me an assignment to write an article about when we should see an endo. I started to work on it, but then the editor left the magazine and the new one didn’t want the article.

Meanwhile, however, I had asked Bill for some ideas for the article. His thoughts were so good that I encouraged him to publish them on his site. He also authorized me to reprint his article on my website at “When to Go to an Endocrinologist”.

You can read in that article about the nine situations when you need to see an endo. If you are in one of those situations, go for it. Just remember that you will likely have a long wait for your first visit.

This article is based on an earlier version of my article published by HealthCentral.